Individual provider Active NPI

Tyler Lebouef, MD

  • Emergency Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1134757909
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
331068 Issued in LA
Practice address
5246 Brittany Dr
Baton Rouge, LA 70808-9136
Phone
(225) 757-4142
NPI assigned
Mar 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 331068 LA Primary

Addresses

Primary practice location

5246 Brittany Dr
Baton Rouge, LA 70808-9136

Mailing address

5246 Brittany Dr
Baton Rouge, LA 70808-9136
Phone (225) 757-4142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220817000422 LA Practitioner - Emergency Medicine 2264855741 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Stick Emergency Group LLCGroup PAC ID 2062583578, 33 clinicians

Practice addresses (Care Compare)

14105 Hwy 73
Suite 100
Prairieville, LA 70769-3626
Phone (225) 402-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
91.13
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
331068LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Red Stick Emergency Group LLC Emergency Medicine CurrentSince Nov 16, 2022 Accepting new patients
Emergency Group of St Landry LLC Emergency Medicine CurrentSince Jul 17, 2022 Accepting new patients
Leatherwood Emergency Group, LLC Emergency Medicine CurrentSince Jul 4, 2022 Accepting new patients

Locations

3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615

8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000

130 Hospital Dr
Oakdale, LA 71463
Phone (318) 215-3084

14105 Highway 73
#100
Prairieville, LA 70769
Phone (225) 402-2600

800 E Main St
Ville Platte, LA 70586
Phone (337) 363-5684

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1134757909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 BRITTANY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089136",
            "telephone_number": "225-757-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 BRITTANY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089136",
            "telephone_number": "225-757-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOUEF",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "331068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.